Abstract:
BACKGROUND: Kangaroo mother care (KMC) is a safe and effective method of caring for low birth weight infants
and is promoted for its potential to improve newborn survival. Many countries find it difficult to take KMC to scale
in healthcare facilities providing newborn care. KMC Ghana was an initiative to scale up KMC in four regions in
Ghana. Research findings from two outreach trials in South Africa informed the design of the initiative. Two key
points of departure were to equip healthcare facilities that conduct deliveries with the necessary skills for KMC
practice and to single out KMC for special attention instead of embedding it in other newborn care initiatives.
This paper describes the contextualisation and practical application of previous research findings and the results of
monitoring the progress of the implementation of KMC in Ghana.
METHODS: A three-phase outreach intervention was adapted from previous research findings to suit the local
setting. A more structured system of KMC regional steering committees was introduced to drive the process and
take the initiative forward. During Phase I, health workers in regions and districts were oriented in KMC and
received basic support for the management of the outreach. Phase II entailed the strengthening of the regional
steering committees. Phase III comprised a more formal assessment, utilising a previously validated KMC
progress-monitoring instrument.
RESULTS: Twenty-six out of 38 hospitals (68 %) scored over 10 out of 30 and had reached the level of ‘evidence of
practice’ by the end of Phase III. Seven hospitals exceeded expected performance by scoring at the level of
‘evidence of routine and institutionalised practice.’ The collective mean score for all participating hospitals was
12.07. Hospitals that had attained baby-friendly status or had been re-accredited in the five years before the
intervention scored significantly better than the rest, with a mean score of 14.64.
CONCLUSION: The KMC Ghana initiative demonstrated how research findings regarding successful outreach for the
implementation of KMC could be transferred to a different context by making context-appropriate adaptations to
the model.
